Background: The quality of life of caregivers whose patients are undergoing PD is significantly changed by home treatment. The mental and social status of caregivers directly affects the quality of the patient care.
Methods: We have conducted a questionnaire based survey for the 33 caregivers of 24 PD patients at our dialysis center. We examined the social and mental status of the caregivers and compared it by evaluating the questionnaire scoring the burnout level (Zarit Caregiver Burden Scale (CBS).Results: According to the CBS scores, 16 of the caregivers didn’t show signs of burnout and 12 patietns showed signs of burnout. 84% (28/33) of the caregivers felt the excessive responsibility a burden. Among the burnout groups, 15 of the 17 relatives had higher education. The burned out caregivers live among better living conditions, more of them are in active work status, while the earning indicators of the non-burned out ones are lower. We found a correlation between the method of treatment and the burnout status. We found a significant connection between the occurrence of complications and the level of burnout. We didn’t find a correlation between the time spent in PD care and the burnout degree. Conclusion/Application to practice: Care of the PD patient poses a higher burden for active relatives. The occurrence of negative change in the interpersonal relationships of the patients must be examined in the background of recurring complications. One of the reasons for the emergence of burnout may be excessive responsibility.

Background: Nursing practice in the haemodialysis unit has to be a balance between technical practice and human care of patients who are vulnerable to processes’ independence/dependence and health/illness. In fact, it became increasingly important to evaluate perceptions and experiences of health care professionals to understand the care concept in terms of nurse behaviours as perceived by patients.Objectives: To describe the subjective perceptions of the patient under nurse care and to analyse the verbal and non-verbal expressions of the nurse’s emotions and feelings during the provision of care.Methods: The study is based on the analysis of 19 detailed qualitative interviews of patients treated at a dialysis centre in Braga, Portugal. The open-ended questions were selected according to a dynamic method and each body sense matched accordingly.Results: The results showed that the patient’s perception of the nurse varies according to the interpersonal interaction. Moreover, non-verbal communication is of particular importance, as it is the case of the vision and tact. With regard to the visual sense, seeing is much more than looking, because the visual image triggers emotions. The eyes are large mobilizers of the senses and 70% of the body's senses are receptors in the eyes.Conclusion/Application to practice: Patients were found to give highest regard and tend to feel that listening to them, touching them, and treating the patient as an individual are the most important behaviours of nurses during the provision of care.

Background: The prevalence of poor sleep quality and sleep disorders in haemodialysis patients is high. Sleep disorders are known to be associated with a poor quality of life and may lead to an increased mortality risk. Intensive haemodialysis regimens are reported to improve several outcomes in dialysis.Objectives: To investigate whether nocturnal home haemodialysis (NHHD) patients have a better sleep quality as compared to conventional haemodialysis (CHD) patients.Methods: 62 patients from five dialysis clinics on NHHD for more than 6 months (mean age 44.4±13.4 years) and 62 propensity score-matched control patients who remained on CHD (3x4 hours/week, mean age 44.7±14.3 years) were enrolled in the study. All NHHD patients received 7-8 hour haemodialysis three-times weekly. Quality of sleep was measured using the Pittsburgh Sleep Quality Index. Subjective sleep quality, sleep latency, sleep duration, sleep efficiency, sleep disturbance, use of sleep medication, and daytime dysfunction were determined and compared between the two treatment arms. Global Pittsburgh Sleep Quality Score ≥5 indicates poor sleep quality. The differences of mean scores were evaluated by means of independent t-test.Results: The Global Pittsburgh Sleep Quality Score was significantly lower in NHHD patients than in CHD patients, indicating a better sleep quality (4.31±3.11 vs 6.79±4.15, respectively, p<0.001). The frequency of poor sleep quality was 35.5% in NHHD patients vs 59.7% in CHD patients (p=0.01). Thus, superiority of NHHD was evident in all sleep quality components, except for sleep latency (p=0.08). Conclusion/Application to practice: Nocturnal home haemodialysis patients reported significantly better quality of sleep as compared to conventional haemodialysis patients.

Background: Black, Asian and minority ethnic (BAME) people are at greater risk of developing organ failure, less likely to be organ donors and wait longer for transplants (Randhawa, 2011).Objectives: To describe our methods to engage with people from BAME communities to address the above.
Methods:Using our award winning and proven Peer Educator (PE) model that involves people from the targeted community, trained to engage with members of their community. They have a cultural, linguistic and religious empathy with them. Our training courses are at accredited standards. We have developed written and DVD resources to support the PEs work.Results: Overall, we have trained 120 PEs, reached more than 25,000 ‘at risk’ people, with more than 2,700 signing up to the organ donor register. We received an award from the Association of Medical Research Charities. Our first project focused on preventative health messages and after qualitative evaluation, demonstrated that people from the community were beginning to make important lifestyle changes to reduce their kidney disease risk factors. Recognising the need for sustainability, we are effectively engaging more strategically with local and national key religious and policy leaders to help champion and sustain our work.Conclusion/Application to practice: The model has been found to be a culturally sensitive, flexible and highly adaptable in addressing early disease detection, prevention, end-of-life issues and organ donation. The intent is to continue to build on our 10+ years of experience. This will be especially pertinent as the proportion of BAME communities continues to increase in Europe.